Last week, news emerged that Ottawa teenager Cole Nicholls, who went public a year ago about his struggles with addiction, had died of a suspected overdose. Nicholls had been outspoken about the toll the opioid crisis is taking on young people in Ottawa. In the days ahead, we will look at the progress being made and the challenges that remain in the battle against opioid addiction and fentanyl.

Andrew Hendriks wants more people talking about how to prevent overdoses.

To make his point, the chair of the city’s task force on overdoses cites a recent figure from the provincial coroner’s data: 60 per cent of people were alone at the time of their overdose-related death.

“The messaging we have been trying to promote over the past year is to not inject or not use drugs alone,” Hendriks told this newspaper. “That’s a message we have to keep reinforcing.”

After Ottawa police in late 2016 raised concerns about fentanyl showing up in street drugs, the task force on April 21, 2017, put out a warning about a sudden increase of suspected drug overdose-related visits to emergency departments in Ottawa hospitals.

One year later, the task force’s work hasn’t slowed.

In addition to health unit workers, there are representatives from community health agencies, hospitals, pharmacies, emergency services, mental health providers and the regional coroner’s office who sit on the overdose prevention task force. The task force originally launched in response to overdoses related to ecstasy. The group shifted its focus to opioids by the start of 2017, responding to a national crisis.

Ottawa Public Health is the city’s lead agency in combatting the opioid crisis, but Hendriks said the work involves a network of service providers.

“Opioids and substance use is a complex issue, and I don’t think one single agency can lead it,” he said. “Just because of the complex nature of the opioid crisis, it really takes the whole community and all community partners to lead in different ways.”

Hendriks said the city is making progress in some areas, such as increasing communication in the community about opioids. The health unit has reached out to parents through information sessions and on Facebook. More than 12,000 local students watched presentations by public health nurses on substance use last year. The health unit also focused on providing training to local bars and festivals.

Naloxone distribution has been another bright spot. Hendriks said more than 180 pharmacies distribute the life-saving overdose antidote and they have distributed 16,000 kits through a provincial health program that started in late 2016. That’s a pretty good number compared to other cities, Hendriks said.

“We have engaged partners. We have pharmacists in the community who are championing this,” he said.

Surveillance and data collection has been another major endeavour. The task force set up an “early warning system” in spring 2017, making sure statistics are collected when someone shows up at an emergency department with a suspected opioid overdose. Those numbers are available to the public through the city’s open data website.

There were 15 emergency room visits because of suspected drug overdoses during the week of April 9, the most recent data available. The number is at the low end compared to the weekly statistics published by the health unit since November 2015. The most suspected overdoses leading to emergency room visits happened during the week of Sept. 11, 2017, when 43 people went to the hospital.

Injection sites

When it comes to reducing opioid-related deaths, plenty of focus over the past year has been on supervised injection sites.

The opioid crisis convinced the health unit to open a temporary supervised injection site at its clinic on Clarence Street last September. Health Canada allowed the health unit to use the federal exemption granted to the Sandy Hill Community Health Centre to provide the service. Now, the Sandy Hill health centre has opened its supervised injection site and the health unit is asking the feds to make the Clarence Street clinic a permanent injection site. There is also a supervised injection site in a trailer at the Shepherds of Good Hope. The Somerset West Community Health Centre is waiting to finish renovations before starting its own injection site.

While the health unit and community health agencies create services to monitor drug users so they don’t die, Mayor Jim Watson has asked the province to spend more money on drug-treatment programs in Ottawa.

Hendriks wants more consideration given to the reasons that lead to opioid overdoses.

“What I’d like to see happen is to continue having discussions around how we prevent overdoses from taking place,” Hendriks said. “We know that employment, housing and income are all part of it.”

According to Hendriks, recent data from the provincial coroner suggests half of people who died from overdoses weren’t employed. One creative way of providing employment is by hiring people to work at supervised injection sites who have “lived experience,” he said.

“People with lived experience have a lot of knowledge and experience on how to support people who are suffering from addictions, and they can play a role in providing these services back to the community if they’re comfortable doing so,” Hendriks said.

For people in the business of prevention and health promotion, Hendriks said it’s critical to expand their view when searching for root causes.

“We can’t be complacent,” he said. “We need to be persistent and think about all aspects of the opioid crisis.”